title: Educational intervention in cancer outpatient clinics on routine screening for emotional distress: an observational study.
abstract: OBJECTIVE
  To examine the possible effect of an educational model on distress screening in newly diagnosed cancer patients referred to Psycho-oncology service (POS).
  
  
  METHODS
  We examined the differences in distress and problems among newly diagnosed cancer patients referred to POS by cancer care professionals' according to their clinical judgement (2-year period; Study-1) and after an educational intervention on the Distress Thermometer (DT) and Problem List (PL), with referral to those reporting cut-off scores indicative of 'caseness' (DT>4) (1-year period; Study-2).
  
  
  RESULTS
  In Study-1, 153 (6.7%) of 2268 new patients were referred and seen by the POS, which submitted each patient to the DT/PL. About one-third of the patients (31%) were not DT-cases (scores < 4) and showed lower levels of emotional and relational problems than those who resulted DT-cases. In Study-2, of all newly diagnosed cancer patients (n = 1107), 583 (52.6%) were administered to the DT/PL by nurses. Two-hundred and eighty-four (52.2%) resulting DT-cases were referred to POS and, of these, 133 (12% of all new patients; 22.81% of those screened; 46.8% of cases) were seen by the POS. There were significant differences in problems between not referred (DT-non-cases) and referred patients (DT-cases).
  
  
  CONCLUSIONS
  Because of the observational nature of the study, the conclusions should be drawn with caution. The implementation of the routine use of DT/PL seemed to determine a higher (79% increase) and more accurate referral of patients but the rate of acceptance was not high, confirming that more effort is necessary in implementing optimal psychosocial care in oncology.
authors.affiliation: Section of Psychiatry, Department of Medical Sciences of Communication and Behavior, University of Ferrara, Ferrara, Italy. luigi.grassi@unife.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Grassi
authors.forename: Elena
authors.initials: E
authors.lastname: Rossi
authors.forename: Rosangela
authors.initials: R
authors.lastname: Caruso
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Nanni
authors.forename: Stefania
authors.initials: S
authors.lastname: Pedrazzi
authors.forename: Stefania
authors.initials: S
authors.lastname: Sofritti
authors.forename: Silvana
authors.initials: S
authors.lastname: Sabato
mesh_terms: D000223:Adaptation, Psychological; D000275:Adjustment Disorders / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007318:Inservice Training; D007558:Italy; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012803:Sick Role; D011795:Surveys and Questionnaires